Malignant tumors requiring maxillectomy

Seventy cases with malignant tumors requiring maxillary resection in the pa st 10 years were reviewed, retrospectively. The primary site of tumor was a djacent skin in 53%, maxillary sinus or maxilla in 20%, palate and alveolar arch in 13%, lip and buccal mucosa in 13%, and mandible in 1% of the cases . The most common histopathological diagnoses was squamous cell carcinoma ( 54%), followed by basal cell carcinoma (20%). Most of the patients had adva nced tumors, either neglected or recurred. Orbital exenteration was perform ed in 28 cases, mandibulectomy in six cases, combined craniofacial resectio n in seven cases, and radical neck dissection in 18 cases. Major skin loss was present in majority of the patients. Postsurgical defects were. reconst ructed with pedicled flaps in 37 cases and free flaps in 12 cases. Lining o f the maxillary sinus defects was provided with split-thickness skin grafts . Patients with palatal defects were encouraged to use prosthetic obturator s. Postoperative radiotherapy was performed in. 32 patients and combined ra diotherapy and chemotherapy in 12 patients. Communication could be establis hed with only 52 patients. Sixty-three percent of them have survived withou t recurrence and distant metastasis. Resection of the tumor with free surgi cal margins and:appropriate evaluation of the surgical defect for the most suitable reconstruction are the mainstays: of treatment of the midfacial tu mors.